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Statement to be furnished by an eligible investment fund to the Assessing Officer under section 9(12) [Schedule I: Paragraph 1(4)]

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....ote 1) 2. Address: (refer Note 2) 3. Permanent Account Number (PAN): (refer Note 3) 4. Tax Identification Number (TIN) in the country/region of residence:   5. Country of residence:   6. E-mail Id:   7. Contact Number: Country Code Number     Part B: Other Information 8. Financial Year for which the st....

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.... Percentage interest Date of agreement 1.         2. (Repeat, if required)         14. Details of Fund Manager(s) in India rendering services for or on behalf of the Fund: Sl. No. Name of the Fund Manager PAN Securities and Exchange Board of India (SEBI) Registration Number 1.     &....

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.... Signature: Name: Designation: Notes: 1. The name shall include full name of the eligible investment fund. 2. The address shall include flat/door/building, road/street/block/sector, area/locality, post office, town/city/district, state, country and pin code/zip code. 3. TIN in the country/ specified territory of residence. In case no such number is available, then a unique num....

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